Individual
MRS. ASHLEY PETTAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S
Contact information
Practice address
1050 REGAL POINTE TER, APT 206, LAKE MARY, FL 32746-2028
(267) 980-4556
Mailing address
247 FAIRFIELD DR, SANFORD, FL 32771-6817
(407) 448-6678
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/17/2015
Last updated
01/16/2022
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